Answers from the Experts: Q&A - March 2024

Do you have questions about cutaneous lymphoma and/or treatments? Our clinical Q&A's are a great way to learn more and empower yourself with knowledge from experts in their field.
Clinical Panel
Ellen Kim, MD, Perelman School of Medicine
Lauren Pinter-Brown, MD, Chao Family Comprehensive Cancer Center
Timestamps
2:09 Please discuss the advantages/disadvantages of steroid ointments versus non medicated ointments. Should steroids be used regularly or only during flares?
4:09 Are there recent advancements in staging and treatment of folliculotropic MF?
6:12 When patients are being treated with a systemic therapy (oral or injectable), but still have a few bothersome patches or plaques, do you offer a topical treatment in addition?
7:08 Is there any early indications at diagnosis which can predict who’s going progress from stage IA to advanced stage?
8:30 What percentage of people with Sezary get a second malignancy and how long after diagnosis? Is there an updated life expectancy?"
11:11 How does moisturizer helps people with MF and how often we should moisturize?
12:33 My husband has MF, diagnosed six months ago. Stage 3. He has had full-body radiation, and now is on Bexarotene. The itch is far less bothersome, and his skin is sometimes clear. But we are finding that he gets rash flares every few days, and they resolve themselves in a few days, and then another one comes. Is this expected?
13:31 Is there an optimal amount of time for full body direct sunlight?
17:11 Does brentuximab carry long term side effects?
17:56 Is topical steroid enough? Does not doing any therapy alter the course?
20:07 Is there any differential utility to knowing the type of LyP one has?
20:49 Do you recommend photolight therapy as a preventative treatment? How effective is it, and would you recommend it to younger patients who would be getting the treatment for a long period of time?
22:15 Regarding sunlight, should it be directed mainly to the areas involved or the entire body?
24:28 Can you elaborate on the in-clinic or home therapy UV protocol?
26:01 I was diagnosed with PCALC in 2018 and again in 2020. What is the likelihood of a recurrence of the disease now that it is 3+ years since the last event?
26:55 For someone recently diagnosed with Stage 1 MF, what are the key first steps to take?
30:12 Does recurrent folliculitis in a patient of MF also suggest a possibility of follicular MF?
31:18 Have other patients reported immediate correlation between mental stress and the manifestation of the lesions?
32:54 What treatments are available for Sezary with TP53 deletion?
33:51 Are there any permanent solutions for itch?
36:29 If left untreated, could patches turn into plaques with more blood involvement, or possibly turn into another type of cancer? What might I try to stop this rapid progression? Does it matter if patches cover over 80% of your body? Can it impact longevity?
39:46 Recommendations for how to manage an automimmune disease (Crohn's), as well as Stage 1 MF. Do you recommend a specialty center?
41:07 How do you know if MOGA is working? What are some options for next steps if it is not?
43:58 Are there any precautions for diet or daily routine?
45:43 I am stage 1A with a single Grade 3 lesion. Can you explain what a grade 3 lesion, in accordance with the Hodak system means?
47:33 Have you seen patients with minimal skin issues have cancer spread internally to an organ or lymph node?
47:59 Has any relationship been found between Covid triggering primary cutaneous lymphoma? Do you recommend getting Covid vaccine whenever recommended by CDC like it was recently?
48:33 I have cutaneous B-cell lymphoma that presents as small bumps on my head. Do these need to be treated? My dermatologist says only if they are bothersome, which they are not.
49:59 I have been diagnosed with lymphomatoid papulosis. After diagnosis, I developed other issues, including cutaneous sarcoidosis. Do you see a correlation between LyP and other autoimmune skin issues?
50:31 Can the HPV vaccine be taken if someone has MF?
51:06 My oncologist recently introduced the concept of a stem cell transplant. At what stage in an CTCL - MF journey might stem cell transplant become a reasonable treatment option? In your experience, what makes a candidate suitable for a transplant and what is the success rate of stem cell treatment for CTCL - MF over the short and long term?
52:39 My doctor told me to think of early stage MF as a chronic rash vs cancer. Is this a good attitude to have or do I need to be more vigilant and check my skin for any changes
53:43 I've had large parapsoriasis since childhood. Recent biopsy and IHC has diagnosed as MF Tumor Stage. No blood involvement. PET CT pending. What should be the next steps for diagnosing and treatment? Is PUVB a potential solution?
55:39 Is flow cytometry a good enough test to rule out peripheral blood involvement?